Study of efficacy of tissue Doppler imaging in diagnosing systolic and diastolic dysfunction and comparison to the conventional methods of left ventricular function assessment in heart failure patients

Objective: The study aims to ascertain left ventricular (LV) mitral velocity, systolic Sa, and diastolic Ea measured by tissue Doppler imaging (TDI) and compare with conventional parameters of assessment of LV function in patients with heart failure (HF). Background: HF is a major cause of disability and morbidity all over the globe, and there are increasing trends in epidemic proportions shortly considering the early onset of cardiovascular disease. TDI is a noninvasive method to assess the LV dysfunction both systolic and diastolic. TDI can be helpful as a diagnostic, prognostic tool in patients with HF. Materials and Methods: A total of 100 cases (72 male and 28 female) admitted to Osmania General Hospital with symptoms and signs of HF were studied. All patients underwent echocardiography, and their LV function was assessed by TDI. Peak velocities during systole Sa, early diastole (Ea), and late diastole (Aa) were measured and compared with conventional LV systolic (LV ejection fraction [LVEF]) and LV diastolic Doppler echocardiography (E/A). Results: In patients with HF, TDI parameter Ea in the assessment of diastolic dysfunction (DD) was statistically significant when compared with conventional Doppler echocardiography 79% and 67% respectively in diagnosing diastolic dysfunction (P < 0.01). The TDI parameter “Sa” used for systolic dysfunction less significantly correlated with LVEF (66% vs. 89%). Conclusion: TDI parameter “Ea” was the most powerful predictor of LVDD when compared to “E/A” Doppler echocardiography. LVEF was a more powerful indicator of LV systolic dysfunction when compared to Sa of TDI. TDI “Ea” and “Sa” parameters can be helpful as diagnostic, prognostic markers in HF patients with low ejection and normal EF.